Abstract : ABSTRACT It is important in the present day to ensure that the social activities of COPD patients are carried out without any problem as part of the goals of approach to and treatment of COPD patients for minimizing both labor loss and financial losses. The use of socioeconomic and demographic characteristics of COPD patients as a tool during their assessment is increasing in importance. Hence, the purpose of the present study was to examine the impact of exercise on blood gases in COPD patients. A total of 378 patients with ages ranging between 45 and 82 who have applied to the pulmonary diseases polyclinic and emergency of our hospital or who have been admitted to the clinic during March 2019 and December 2019 were included in this prospective study. All of the 160 patients with emphysema and 218 patients with chronic bronchitis were stable. Cases with accompanying diseases other than respiratory system disorders (cardiac, diabetes mellitus etc.) and patients in acute attack were excluded from the study. Of our cases, 180 (47.62 %) were female and 198 (52.38 %) were male with an age average of 60.95+5.7. End of exercise respiratory rate increase, (p:0.003), PaO2 increase (p:0.008), PaCO2 increase (p:0.005) and pH decrease (p:0.009) were observed to be statistically significant in chronic bronchitis predominant patients. End of exercise respiratory rate increase (p:0.006) along with decreases in pH (p:0.008) and PaO2 (p:0.009) were observed to be statistically significant in emphysema predominant patients. Exercise training is important for the rehabilitation of COPD patients and increases their quality of life. Hence, we concluded that that it may be beneficial to determine the end of exercise blood gases of stable COPD patients for planning their residential treatment. Keywords: Chronic Obstructive Pulmonary Disease, exercise, arterial blood gas

Keyword : Chronic Obstructive Pulmonary Disease, exercise, arterial blood gas

Abstract : It is important for surgeons and anatomists to have an understanding of thickness, diameter and variability of the brachial artery in the upper limb. As the variability of the brachial artery presents, the possibility of frequent vascular injury needs to be considered during a number of surgical and invasive procedures. Objective: The present study aims to perform a morphometric assessment of brachial artery with respect to clinical implication of its high termination and correlate it with its embryological basis. Methods: Routine dissections of the right and left upper limbs of 36 adult cadavers were done and observed for variations in the branching pattern of brachial artery. The measurement of brachial artery and its level of termination were taken at two levels. The internal and external diameters of the brachial artery along with the thickness of the brachial artery were measured at three different levels. Results: The higher division of termination of brachial artery into ulnar and radial artery was found at mid-arm level. The average length of brachial artery on right and left side was side was 23.39 cm and 22.36 cm respectively. The internal and external diameter of brachial artery was significantly larger on right side than left. In addition, the thickness of the middle part of brachial artery on left side was significantly (P<0.05) larger than the right side. Conclusions: The present study will enhance clinician’s awareness of potential arterial variations and morphometric assessment of brachial artery will help clinicians and surgeons for more accurate diagnostic evaluation and surgical management of vascular injuries and diseases.

Keyword : Brachial artery bifurcation, Radial artery, Ulnar artery, Vascular anomaly, Clinical implications, Surgical interventions.

Abstract : During recent years the usage of CT in EDs has increased greater than before. Although there is a consensus to scan patients with moderate or severe head trauma urgently, an ongoing debate continues as to which patients with mild head injury should be scanned.In our study we aimed to compare the CCHR, NOC, and NEXUS-II rules to identify the clinically significant brain injuries. Acute mild head injury was defined as a closed head injury by blunt force within 24 hours, with a Glasgow Coma Scale (GCS) score of 13 to 15. All patients who visited our ER with minor head trauma were enrolled in study prospectively, and all CCHR, NOC, and NEXUS rules were evaluated separately for each patient. The determined outcome lesions were subarachnoid haemorrhage, subdural hematoma, contusion, epidural hematoma, skull fracture, intraparenchymal haemorrhage, and cerebral oedema.The sensitivity, specificity, and predictive values with 95% confidence intervals (CIs) for the performance of each rule for CT scan and each criterion of rules and all symptoms predicted to be caused by head trauma were calculated. P < 0.05 was considered statistically significant. RESULTS: A total of 140 patients were included in the study. The mean age of the patients included in the study was 55.59 ± 23.258 (median 57.00)years . Of all patients, 62.1% (n: 87) were male and 37.9% (n: 53) were female. In terms of gender, it was found that men had more minor head trauma. The mean age of male patients was 49.90 and 64.94 for female patients. Among whole study population, 43.57% (n = 61) of the patients were 65 years and older. Sensitivity, specificity, and positive predictive value negative predictive value of NOC were 87.5%, 6.57%, 44.09% and 38.46%, respectively. The sensitivity of CCHR rule was 82.81%, its specificity was 32.8%, its positive predictive value was 50.96%, and its negative predictive value was 69.4%. The sensitivity of NEXUS II rule was 93.75%, specificity was 3.94%, positive predictive value was 45.11%, and the negative predictive value was 42.85% Additional studies may be demonstrated by focusing specifically on the sensitivity and specificity of each criterion separately. Additionally, more studies should be performed especially in geriatric population to specify a criterion for each rule separately.

Keyword : Head Trauma, CT rules, EmergencyMedicine